Dyslexia and Arrowsmith Program: A Language‐Based Disability That Can Require More Than Just Phonological Awareness Training and/or Phonics Remediation
There is no question that early phonological awareness training is critical for children who are learning to read. There is a substantial bank of research available now that shows how important it is to give children this early training in the sound structures of spoken words. The International Dyslexia Association highlights this point, stating that “If children who are dyslexic get effective phonological training in Kindergarten and 1st grade, they will have significantly fewer problems in learning to read at grade level than do children who are not identified or helped until 3rd grade. 74% of the children who are poor readers in 3rd grade remain poor readers in the 9th grade.”i
In 1972, I was diagnosed with Severe Developmental Dyslexia. I was in Grade 2. I was not reading. My teachers had tried to use the “whole word” method of teaching reading. They would hold up index cards with words printed on them and then ask the class to look at the word and say it. I would sit at the back of the classroom, looking at the word, waiting for the other children to pronounce it so that I could follow them with my pronunciation milliseconds later. When it was my turn to read on my own I would turn red in the face with embarrassment and look down at the floor. The teacher would move on to the next child.
The child psychiatrist who diagnosed my Dyslexia informed my parents that I should receive an intensive phonics program called Orton‐Gillingham. My parents quickly hired a tutor and, over a period of five years, I slowly began to learn to read, although my spelling remained inconsistent for some time. There was no doubt that the Orton‐Gillingham program gave me the ability to decode the English language. It was not easy, but I eventually mastered the skill of word decoding. Despite my gains in this area, however, I struggled with spelling, fluency and comprehension for years.
My problems with Dyslexia did not just affect my reading skills. I also had difficulty with auditory memory for phrases of information and instructions. I struggled to acquire a second language as a result of my continued auditory discrimination difficulties. My word findings abilities were weak; thus, my expressive language was weak. As a result, I was quiet and shy as a child and adolescent. The phonics program that I received did not provide the necessary cognitive remediation to improve my weaknesses with language processing, memory and retrieval. I did learn to read ‐ this was critical; however, if there were a way to improve these other language weaknesses that are so often apparent in children with Dyslexia, would one not want to consider this path?
The International Dyslexia Association provides a definition of Dyslexia. It is important to review this definition and to consider the type of intervention that could most directly affect each of the symptoms of Dyslexia highlighted. The association states:
Dyslexia is a language‐based learning disability. Dyslexia refers to a cluster of symptoms, which result in people having difficulties with specific language skills, particularly reading. Students with dyslexia usually experience difficulties with other language skills such as spelling, writing, and pronouncing words. Dyslexia affects individuals throughout their lives; however, its impact can change at different stages in a person’s life. It is referred to as a learning disability because dyslexia can make it very difficult for a student to succeed academically in the typical instructional environment, and in its more severe forms, will qualify a student for special education, special accommodations, or extra support services.ii
The description of Dyslexia continues:
Some dyslexics manage to learn early reading and spelling tasks, especially with excellent instruction, but later experience their most debilitating problems when more complex language skills are required, such as grammar, understanding textbook material, and writing essays. People with dyslexia can also have problems with spoken language, even after they have been exposed to good language models in their homes and good language instruction in school. They may find it difficult to express themselves clearly, or to fully comprehend what others mean when they speak. Such language problems are often difficult to recognize, but they can lead to major problems in school, in the workplace, and in relating to other people. The effects of dyslexia reach well beyond the classroom.iii
It is clear that learning problems related to Dyslexia can go far beyond reading and spelling difficulties. Intervention programs for Dyslexia often focus on reading and spelling. The other neurological weaknesses connected with Dyslexia, such as problems with spoken language and the understanding of more complex language, are often not addressed. The child with Dyslexia therefore learns to read and improve spelling ability through the use of a phonics program, but still struggles with reading comprehension, finds it difficult to memorize auditory information and instructions, and has limited expressive language ability.
Researchers now consider Developmental Dyslexia and Specific Language Impairment to actually be the same problem, differing only in severity and developmental stage.iv A Specific Language Impairment is a developmental disorder than can impact expressive and receptive
language. Researchers are discovering that children with Developmental Dyslexia often have the same problems as children with Specific Language Impairments (SLI). Those studying this association have stated that Dyslexia researchers seem to over‐emphasize weak phonological processing as the cause of reading difficulties.
In the field of dyslexia, there has been an overwhelming emphasis on poor phonological processing as a cause of reading difficulties. However, study of children with oral language problems indicates that difficulties with semantics, syntax, and discourse will also affect literacy acquisition; in some children (so‐called poor comprehenders) these difficulties may occur without any phonological impairment. In more classic cases of SLI, there can be both phonological and nonphonological language impairments that affect learning to read.v
As noted previously, oral language problems impact not only literacy, but classroom functioning as well. If a child with Dyslexia struggles with receptive language, he or she may experience significant problems following classroom instructions and understanding general information.
If this child has expressive language difficulties he or she may not speak up in class, self‐ advocate, or share knowledge with peers.
It is also important to note that Dyslexia may be caused by additional neurological deficits not addressed through phonological training. Reading and spelling requires not just sound discrimination processing, but also the ability of the child’s brain to process, memorize and retrieve the orthographic patterns (letter patterns) of words. Researchers have used the term Visual Dyslexia, or Orthographic Dyslexia, to describe children who struggle with this area of neurological functioning.vi Nathlie Badian in an article entitled: Does a Visual‐Orthographic Deficit Contribute to Reading Disability (2005)vii stated:
In spite of the significant roles of phonological awareness and naming speed in reading development, these two variables leave a considerable proportion of the variance in reading unexplained, which leads to the logical hypothesis that other, unspecified, variables are contributing additional variance to reading. Basic visual‐orthographic skills such as the accurate recognition of letter orientation may be among those variables.
This study indicates that there are some children whose reading development continues to be hampered by a problem in orthographic memory for the orientation of letters (and numerals) long after most children have easily mastered this task. The problems of such children
require special attention, but may be overlooked, especially if, as is frequently the case, they also have naming speed and/or phonological awareness deficits.viii
The cause and symptoms of Dyslexia are quite varied, and depend on the specific neurological strengths and weaknesses of each child. It is important to recognize that phonological awareness training is not the only intervention for students with Dyslexia, and that it does not address all causes and symptoms of Dyslexia. However, as noted at the beginning of this article it is a very important intervention and should be implemented at the early stages of reading instruction. Additionally, phonic‐based reading remediation programs are also valuable and provide a critical component of an intervention program.
The problem for children with Dyslexia today is that these intervention programs do not provide all of the necessary cognitive training required to improve language impairments and possible visual‐orthographic weakness. In addition, in some cases of severe Dyslexia, the number of neurological deficits may be so significant that a phonics‐based reading program may not be immediately helpful for that child. Cognitive training to strengthen these neurological capacities is required prior to the effective utilization of a phonics‐based reading program.
The Arrowsmith Program is a unique cognitive training opportunity available to children with Dyslexia and other learning disabilities. The program focuses on the many symptoms of Dyslexia, including the specific language impairments often observed (namely receptive and expressive language problems). The Arrowsmith Program also recognizes the different subtypes of Dyslexia that can exists – auditory, visual, or combined auditory/visual neurological deficits. The primary goal of the program is to improve the underlying neurological dysfunctions that are causing Dyslexia. For example, if a child with Dyslexia struggles with receptive language (i.e. difficulty processing speech sounds, and difficulty processing and memorizing general information and instructions), or expressive language, specific cognitive exercises are implemented to improve that particular neurological capacity.
Many areas of the brain are responsible for success, or difficulty, with reading and spelling ability. Arrowsmith Program assessments first identify which of these neurological functions are weak. The student then works on cognitive activities in order to strengthen these areas. For example, when analyzing the activity of reading, four brain regions are considered including Symbol Recognition (orthographic), Brocas (speech sounds), Lexical Memory (memory for words) and Motor‐Symbol Sequencing (visual scanning and tracking of symbols). It has been observed in Arrowsmith Program research that a higher number of neurological weaknesses is correlated with more severe reading disorders. (Please see the following website: http://www.arrowsmithschool.org/images/Arrowsmith_study_11_20_05.pdf.) Additionally, as
these neurological weaknesses improve and move to an average range of function, the child begins to develop reading and spelling abilities. Phonics‐based programs can then be introduced and the child can further develop reading and spelling skills. The Arrowsmith Program recognizes the importance of teaching the sound/symbol structure of the English language once these neurological deficits are improved. Some children working on the Arrowsmith Program had previously received years of phonics training with little success. The same children, after months of cognitive training, begin to develop reading skills; thus, an increase in neurological capacity was required prior to achieving success with reading.
In summary, the Arrowsmith Program does not focus on one particular reason why children with Dyslexia struggle to read and process language. Rather, the program looks at the neurological functions required for these abilities, and generates a cognitive training program specific to each child’s profile. Recognizing the relationship that exists between strengthening cognitive capacities and the acquisition of skills related to academics is an important step in ensuring that each child’s educational plan is designed for success.
iv Bishop, D., & Snowling, M. (2004) Developmental Dyslexia and Specific Language Impairment: Same or Different? Psychological Bulletin, 130, 6, 858‐886.
v Bishop, D., & Snowling, M (2004) p. 858
vii Baden, N. (2005) Does a Visual‐Orthographic Deficit Contribute to Reading Disability? Annals of Dyslexia, June 2005.
viii Baden, N. (2005) Does a Visual‐Orthographic Deficit Contribute to Reading Disability? Annals of Dyslexia, June 2005